Author
Topic: Living in Emergency (LiER) ~Dec 24~ (Read 17313 times)

A product of my procrastination during my break time and down time at work. This is more of something to satisfy my urge to write and a form of entertainment for myself when I'm in my bored moments and don't want to study or do my assignments. Just a warning there might be a LOT of medical term usage and things going on and it will get confusing, I made up a little index with some terms that I will be using frequently and will be updating that as I go. For those that are brave enough to continue on with my craziness please refer to the index to see if it will help explain things out a bit.

Most of the cases that do appear in here are things that I have come across at work mixed with a bit of creativity and imagination. I'm not sure how long this little project will live, probably as long as I have things that bug me at work. There is no set plot for this so this will be a "go with the flow" stories, and the updates will be written on the spot.

Sorry I didn't have time to go over this, so please excuse any errors/ mistakes.

Living in Emergency: PAGE 1

“Respiratory STAT to emergency! Respiratory STAT to emergency!”

Sound of running can be heard ringing down the halls, patients and visitors look up only to see a blur running past them. If not for the blaring overhead announcements they would definitely say it was their imagination playing tricks on them as the image left before it can be registered in their brain.

~~~~~

“Respiratory is on their way doctor,”

“What is the status on the ambulance and patient?” asked Dr. Takahashi as she arrived in the trauma bay.

“They should be here any minute now. Post cardiac arrest found at home by granddaughter who called ambulance. CPR started on arrival by ambulance crew, they were unable to secure a breathing tube on scene.” Kuramochi Asuka, the head emergency nurse quickly summarized the situation.

“Respiratory here, what’s the deal?” asked Sashihara Rino, the in hospital respiratory therapist (RT), who came running through the doors with her partner in crime Minegishi Minami.

“Post arrest coming, please set up for intubation.” Dr. Takahashi yelled out over her response team that are all ready for action.

“Male or female?” Sasshi asked as she started pulling out different sizes of breathing tubes and equipments that will be vital in the next couple minutes.

“Female,” Mocchi replied as she took another look outside to the ambulance loading area, “they are pulling up so any seconds now,” she announced to the team.

The sounds of wheels rolling into the trauma bay can be heard as the ambulance crew came rushing through the doors. A totally of four crew members can be seen, one at the end pushing the stretcher, while another is at the head of the stretcher guiding its path holding onto a chart that contains the patients history. The third one can be seen almost straddling the patient on top of the stretcher performing compressions on the rolling stretcher while the last was at the side of the patients head manually ventilating the patient with a bagger through a face mask.

Once they stopped, the paramedic on the stretcher jumped down and quickly moved out of the way as they transferred the patient onto the hospitals stretcher.

“Alright on 3, 2, 1,” proficiently the paramedics moved the patient over the bigger stretcher as the nurses wasted no time to start connecting the monitors and pads at the same time one can be seen getting in place to continue CPR.

In perfect harmony, the team weaved around each other working against the clock, hoping to bring life back and restart the heart of this poor little lady. Without missing a beat the paramedic recited the patient’s condition and history for everyone present to hear.

“71 year old female found collapsed in the bathroom by her granddaughter, who called ambulance. On scene, we started CPR immediately after finding no pulse, shocked once and rhythm returned with pulse, we were able to get one IV in before we lost her pulse again”

*Dr. Takahashi’s POV*

“Okay let’s do this, continue CPR, and have Epinephrine and Atropine ready!” I ordered, “Sasshi, you intubate the patient,”

I watch Sasshi moved to the head of the bed with the breathing tubes in hand as Miichan stood by her side with their needed equipments for the procedure. Once everything is laid out, Miichan relieved the paramedic and took over manual ventilation until Sasshi is ready to insert the breathing tube, with one hand holding a mask over the patients face, she squeezing the bagger with her other to deliver another breath into the lungs. As the RT’s busy themselves with securing the airways, our skillful nurses, Takajo Aki and Yokoyama Yui, took turns doing compressions. Each of their compressions aimed to circulate blood to preserve the body, by circulating oxygenated blood to keep the brain and organs alive until they are able to restart the heart.

“Dr. Takahashi, we still don’t have a pulse, patient is in PEA (Pulseless Electrical Activity)!” Sato Amina spoke out loud and clear for the team as she paused in her charting to check the pulse.

“Keep up the CPR, Yui give the patient 1mg of Epi IV.” I instructed, watching them quickly carry out their tasks.

With one swift motion Sasshi had the patient’s head repositioned and is looking down her throat with a lighted blade in one hand while pushing the breathing tube into the lungs with the other. Miichan quickly made sure that they have the breathing tube in the lungs and not in the esophagus, before securing the breathing tube.

“Good air entry heard in the lungs, we are in Dr. Taka, airway is secured.” Sasshi reported.

“Dr. Takahashi, 1mg Epi is in.” after reporting to me Yui and Akicha switched position again with Yui performing CPR, I can see Akicha shaking out her arms a bit.

“Stop, check for pulse again.” I watch Amina pause from her recording again and quickly moved to check for a femoral pulse.

“We have a pulse!” she spoke up loud and clear for everyone to hear.

“Stop compressions, get another IV in and give the patient 500mL of fluid IV immediately, get Dr. Shinoda on the phone and alert ICU we have a patient for them and will need to be started on cooling protocol.” I gave out another set of orders as I move to assess the patient.

“Is family here?” I asked as I check over the patient again, her prognosis is poor and given her downtime there is a chance she won’t make it.

*pops in* .... *poke* hai ^^ thought i'd drop by your new fic xPHOLY O.O the whole first post... is a glossary?? lol err... not sure if i wanna start this fic now xP hahahaglad to see other supporting this fic tho ^^ keke see a lot of atsumina shippers...i should probably read this after my MTs to... get a better knowledge of your RT world xP?ganbare~ i'll be back later!

@immortal_K: another comment! this fic reminds me of Grey's Anatomy... but more action in Trauma Bay instead of the Surgery Wing :3I can imagine Dr. Takamina leading the team calmly... when I watch medical drama it's always heart pounding and panicky it's good that grandma in the story is okay... and now me, like the rest of the readers are now wondering who the grand daughter is.

waiting for the next update! i dont wanna troll you about this lol jk~!

aoi_sora: LOL Aamin.. hmmm I will have her in the story for sure I guess you can say it is like Grey's Anatomy, but then that show has more drama in relationships then the actual care and treatment HAHA

blueangel65: Wow so many Atsumina predictions, I hope you are still up for reading after so long.

BLU: I updated again 2 months later, don't worry Acchan will be in this for sure.

Shi-chan: Meep! you can start spazzing again.

Bro: Glad you like it, I will keep this going but I just don't know when I can update. This kind of story I have to write when I'm at work the inspiration is just overwhelming

crazywota: I hope it will make your day again after such a long wait. I think I have a full list of Atsumina fans here.

dark-atrox: Evil buddy, yea I had to add the glossary for people because I throw in so much medical terms and stuff in there.

caghaunt: Yes, Team Medical Dragon, Godhand Teru, Code Blue etc are my fav medical drama's, funny how even though I can see mistakes and errors in the med drama's it doesn't really bother me too much

Kahem: This is AKB's anatomy then?

chibi-nyao-chan: Yup, I plan to use all the members in this story, some will only be cameo's while others will make recurring appearances.

WinterAir: Hey mortal, yes you should read this after your finals.

AFLynx: Yea I thought most of the craziest action usually happens in emergency room and in emergency cases so its the best place to start. Yes Dr. Takamina standing on a stood to over look her team keke.

So after a very long time I finally have time to write up another page of LiER at work I am quite surprise with all the comments I got for this story that I never expect people will find interesting with the millions of hospital/medical stuff that I have added into the writing. As I have mention before, this fic is originally for my self to just spill out things that I have seen and done or heard of at work. Most cases are modified to fit the story but its not fake, and yes every case that will appear I have been there actively participated in the treatment and care with the rest of the team. Personally I believe in the teamwork, I believe that it takes more then just the doctor or the nurses or the RT's etc to provide optimal care and best treatment. So a 'THANKS' to all those health care professionals out there.

This is definitely one of the longest updates I've ever written.

Living in Emergency: PAGE 2

~If everyday is a new page in life, what chapter are you at in your story~

*Takahashi Minami’s POV*

I always dreaded this part of the job the most, I have no problem performing the procedures and caring for the patient, it is speaking with the family that I always have trouble with. I stood outside the family waiting room, hesitating to enter as I can already hear the sobbing coming from inside the room. Just hearing this already have my heart wrenching in pain unconsciously putting myself in their position and feeling the pain they are in. Sometimes this helps me gain a level ground, so I can speak to them in their terms while still keeping a clear mind of the situation.

Pausing for another minute I finally reached to turn the knob to the door, if I stand here any longer I might start getting unwanted stares from the patients and nurses. The sound of opening door caused the sobbing to pause, even before I fully stepped into the room I was bombarded with questions.

“How is she? Will she be alright? Is she going to make it through? This is all my fault!” question after questions were thrown towards me by the granddaughter, all while keeping her head down.

“Calm down and I will slowly explain to you what is going on, have a seat first.” I spoke with the calmest voice I can manage while placing one hand on her shoulder as a form of support. I took out a pack of tissues and pass it to the girl waiting for her to take it and dry her tears.

Finally she lifted her head so I can get a good look at her face, those eyes that stare back at me… I know that face.

“Yuko?”

She stopped crying and started looking at me with this confused look, like a lost puppy or maybe a squirrel… Moments pass by with this awkward silence surrounding us with my hand still on her shoulder while the other one outstretched and still holding onto the pack of tissue.

“Taka-midget?”

That was all it takes for me to confirm she is who I think she is, no one uses that name for me anymore, well at least not together. I was only able to respond her with a nod before I was attacked by a flying squirrel who decided to borrow my shoulders for support and cry on. It didn’t even take long for me to start feeling the wet spot on my shoulder but I wasn’t about to just push Yuko off of me, in contrast I allowed myself to snake my arms around her for a reassuring hug. Tired of standing in the middle of the room with the door still half ajar, I quickly swatted the door closed before moving over to one of the couches. I continue to comfort the crying girl, giving her occasional whispers of encouragement until she is ready to listen to what I have to say. When I felt that Yuko is composed enough for us to talk and discuss her grandma’s situation, I untangled myself and turned over to look at her, making sure to maintain eye contain with the best positive body language I can muster up.

“Yuko, I’m Dr. Takahashi, I was in charge of your grandma’s resuscitation when she was brought into our emergency room.” I start off by introducing myself even thought I suddenly felt a bit silly to introduce myself to someone that I use to talk to on a first name basis. I waited for her to let the words sink in before continuing.

“As you know, your grandma’s heart stopped, but we were able to bring it back. We had to put a breathing tube in to help her breathing because she isn’t able to do that on her own right now. She is also connected to monitors that help us watch her condition while she receives medication given to her through lines that goes straight to her veins.” I paused again to allow her some time to digest all that I have said.

“Will she be okay?” Yuko asked, with hope in her eyes.

“For now she is stable, we will transfer her into intensive care unit for management and care, the doctor and nurses there will take good care of her. We will try our best to do what we can but you have to know this, her heart did stop for a period of time and we can’t predict the amount of damage and impairment it might have caused. BUT we will do our best.” I made sure to emphasize our position in her care to settle Yuko’s mind a bit with her knowing her grandma is in good hands.

“It is all my fault... *sniff* if only I...*sniff* started CPR when I found her lying on the floor in the bathroom…I just blanked out.” Yuko started crying again, “If only I concentrated on my studies instead of always running around causing trouble.”

Once again I placed an arm around her shoulder in a half hug allowing her to wet the other side of my shirt. “Shuuuu, it’s not your fault you were in shock, and you remember to call for help. If you didn’t do that then she won’t even be here anymore.” I spoke gently trying to calm the distress girl.

“But I’m always causing her trouble, getting into fights… she’s all I have left…” tears continue to pour out of her already red and puffy eyes.

I sat there with Yuko in that exact position until I notice her breathing becoming shallower and slower. Using my hand to move her hair to aside I see her eyes now closed as she had cried herself to sleep, energy all spent with traces of tear marks on her face. I debated if I should excuse myself and head back to the emergency room as my duty is to care for those that are sick but seeing how nobody came to check on me, they should be managing the workload. At most the Maeda sisters might just demand a free dinner for doing my share of work, I’m sure I can manage them one dinner, it’s not like I can get away from them anyways.

~~~~~

Dr. Shinoda Mariko, Intensive Care doctor, trained in Internal Medicine and Respiratory Medicine. Studied and practiced in USA, she was one of the top in her class, returning last year to take up a position as one of the ICU doctors. Although beautiful for the eye with looks of a professional model, her personality can occasionally be quite sadist for her staff. Rumors say she goes around trolling all her ICU nurses causing them to resign because they can’t take the constant abuse.

“Wow Mariko, only a year and you already build up quite a reputation, you are so well known here for being the one doctor to avoid at all cost,” two tables down from the gossiping nurses the ICU doctors sat trying to enjoying their coffee. At least one of them was until that peaceful atmosphere was broken by the individual doctor who now has her hands covering her mouth trying to muffle her laugh at her friend’s expense.

“Gorilla, shut up” the icy tone and intense glare intended to silence Sayaka had as much effect as giving a drug user a pinch of morphine. Sayaka just doubled over and tried harder to muffle a second wave of laughing, once settled she lift her head and flashed her friend an awkward smile as she tried to prevent another laughing fit. Mariko attempted to counter it with a deadly glare, but soon it turned into a smirk as the gossiping nurses continue with their live bio broadcast.

Dr. Akimoto Sayaka, director of ICU also trained in Internal Medicine and Respiratory Medicine specialist, also the Head of the department of Medicine and a consultant for the Center for Disease and control. Known as the only daughter of the founder of AKB, she will succeed her father and eventually take over the management. Rumor says Dr. S. Akimoto is strong as a Gorilla and her abs are as hard as a washboard; she is a slave driver and has very high expectations for her staff. Her glares and lectures bring her staffs to their knees breaking even the strongest willed individual.

Sayaka frown after hearing what is being said about her, “You should smile more and don’t glare, we are short on staff, new graduates are scared to apply to the hospital, because we are known to have a scary doctor,” Mariko said with a smirk.

“Well, you should stop trolling them, we lost so many nurses because of your sadist nature,” Sayaka retaliated.

“ICU is fully staffed right now, you don’t see them being scared away” retorted Mariko.

“Correction, ICU is the only unit that is fully staffed, and that is because all the ones that couldn’t stand you…”

“Us” Mariko cut off Sayaka, just to remind her they are in it together.

“the ones that couldn’t stand us left after the first couple months, the one’s WE have left are crazy.” Sayaka finished.

“They aren’t crazy they are just the best of the best.” defended Mariko.

“You are only saying that because Haruna is a part of the ICU staff.” Sayaka got up and headed out of the cafeteria, throwing away her empty coffee cup on the way out. Mariko just sat there starring out the window watching the rain pour out of the sky.

*Beep* *Beep*

Mariko took out her pager to check the number, seeing the local to Emergency she quickly picked up her cell to return the call.

“Hi this is Dr. Shinoda… okay I will be there shortly.”

~~~~~

“Hey Mocchi, where is the little one?” Mariko asked as she strolls into emergency right next to the head nurse while peering through the curtains to get a glimpse of her soon to be patient.

“Dr. Shinoda, Dr. Takahashi went to the waiting room to speak with the family,” Mocchi replied as she continues to fix up the charting to the resuscitation they had performed earlier.

“Alright, I’ll assess the patient first and write you some orders so we can get her moving to ICU as soon as we can. Did we get the chest x-ray for breathing tube placement?”

“Yes, that has been done,” Mocchi replied as she watched Mariko move over to patient’s bedside to start her patient assessment.

“Mocchi, get the papers together we will move this one to ICU first. I want to start cooling her to improve the chances of recovery while minimizing chance of anoxic brain injury. I’ll finish the orders over there.” Mariko told the nurse in charge, “I’ll go ahead and inform ICU so you don’t have to worry about calling them.”

“Roger that, Mariko-sama,” Mocchi said with a smile towards the departing doctor.

“That’s Dr. Shinoda to you,” Mariko joked before walking out the doors of the unit.

“Yui can you page Sasshiko back, we need her to transport the patient to ICU right now. Akicha can you get the portable monitor ready and Amina please draw up some morphine and midazolam, just incase we need something on the way.” Mocchi quickly delegated her staff to get the patient ready for moving.

~~~~~

*Sashihara Rino’s POV*

~After disappearing from the Emergency Room~

“Hi, my name is Sashihara, I am a Respiratory therapist, I came to check your breathing, your nurse told me you were having some trouble earlier.” I introduced myself while analyzing the patient in front of me, his chart said, he is 45years old, came in with pneumonia, some drug and alcohol abuse, depression and history of psych consult.

‘Wow what has this guy been smoking’ I thought as I stared at the guy in front of me.

“You are fine now, they are gone. Do you know where you are and what day it is?” I asked to check and see if he is orientated at all.

“Today, is pay day, I usually get paid every other week on Monday, I have been waiting for today since last week.” he replied.

Yup today is Monday alright, at least he knows the day...

“Hmm you look weird” he suddenly said while looking at me, then he turns and look around the room, “nice place you have here, how much did you pay for rent? I like the colors of the wall.”

I don’t know how to respond, first he calls me weird then he comments on the nice hospital walls..... “Mister you are at Akibahara Hospital, this is a hospital room, it is not for rent but you do have to pay for staying here. I’m going to have a listen to your lungs.”

I moved to place my stethoscope on his back over where the lungs are located and heard some low rattling sounds of crackles and some wheezes. Before I was able to remove my stethoscope from my ears heard some muffled sound “Sorry, you were saying?”

“You look my age, how about we go out and have a nice dinner together?” he asked.

Okay this is so funny and freaky at the same time, first he tells me he was chased by teletubbies, then calls me weird and now he just asked me out for dinner.

“I’m sorry, you can’t leave the hospital yet, I am going to give you some Ventolin and Atrovent, its breathing medications that help open up your airways and make your breathing easier.” I quickly grab one of the medication masks left on the wall and connected it to the wall oxygen flow meter and started it. Once I see the mist of medication coming out I placed it over the patients face.

“WOW, this is pretty cool, feels nice, maybe I should get one of these for myself, it even comes with a tubing to hold it with.” he said while playing with the mask and tubing.

“You can have that mask, for free, just take it with you when you go home.” I said before I slowly eased my way out of the room.

Finally! you posted an updated for this fic! I love how you were able to write Takamina's POV... I can really imagine what she was doing! I was in a good way when I found out that Yuko is the granddaughter. Mariko and Sayaka's scene is great too! Honestly, I would love to go to a hospital that has the AKB members as their doctor's and nurses